Inspection on 13/06/07 for Granby Court Extended Care Unit

This inspection was carried out on 13th June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Granby Court Extended Care Unit 26/01/06

Granby Court Extended Care Unit 04/10/05

Granby Court Extended Care Unit 08/03/05

Granby Court Extended Care Unit 06/05/04

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Granby Court Extended Care Unit Granby Road Harrogate North Yorkshire HG1 4SR Lead Inspector Jo Bell Key Unannounced Inspection 09:30 13th June 2007 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Granby Court Extended Care Unit DS0000027931.V333711.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Granby Court Extended Care Unit DS0000027931.V333711.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Granby Court Extended Care Unit Address Granby Road Harrogate North Yorkshire HG1 4SR Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01423 536361 01423 531002 granbyecu@aol.com Granby Care Limited Mrs Suzanne Ott Care Home 41 Category(ies) of Old age, not falling within any other category registration, with number (41), Physical disability (41) of places Granby Court Extended Care Unit DS0000027931.V333711.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Age range for Service Users in category (PD) and in receipt of nursing care is 50 years upwards. 26th January 2006 Date of last inspection Brief Description of the Service: Granby Extended Care provides nursing care for up to 41 clients. The service adjoins Granby Court and provides both permanent and respite/convalescence care. The home is situated on three floors and has comfortable lounge and dining areas. The bedrooms have en suite facilities in addition to assisted bathrooms. A physiotherapy room is also available. The fees per week are £770-840. Granby Court Extended Care Unit DS0000027931.V333711.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A key inspection of the service took place on Wednesday 13th June 2007. Prior to the site visit a pre-inspection questionnaire was completed and returned to the Commission for Social Care Inspection (CSCI). Seven surveys from people using the service were returned, along with one relatives survey. Five doctors completed comment cards which were also returned to the CSCI. One inspector spent seven hours at the service. During this time observations of care practices took place, discussions with people using the service, a relative was spoken with and a range of staff discussed the service and the training they receive. Time was spent at lunchtime talking with people in the dining room. Discussions with the manager took place throughout the day and a sample of policies and procedures were examined, along with aspects of the environment. Overall people receive care that is delivered to a high standard, many areas of the service had excellent outcomes for people, and only a few areas needed improving. What the service does well: What has improved since the last inspection? The home is owned by Four Seasons Healthcare, and the staff are in the process of implementing a range of different paperwork. The standard of care has been maintained since the last inspection. Granby Court Extended Care Unit DS0000027931.V333711.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Granby Court Extended Care Unit DS0000027931.V333711.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Granby Court Extended Care Unit DS0000027931.V333711.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 (Standard 6 is not applicable) People who use the service experience excellent quality outcomes in this area. Needs are assessed in a comprehensive and detailed manner. This means individual needs can be met. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: Pre-admission assessments take place prior to a person entering the service. The nursing, social, personal and healthcare needs are discussed and recorded in a detailed manner. Either the manager or the deputy carries out the initial assessment and this identifies individual needs and whether the service is suitable for a particular person. Four assessments were examined and these all contained relevant information, three people were spoken with including a relative who confirmed an assessment had been undertaken prior to admission. The manager is aware of the client group and understands how needs can be met. Granby Court Extended Care Unit DS0000027931.V333711.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 & 10 People who use the service experience excellent quality outcomes in this area. Health and personal care needs are consistently met. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: People using this service receive a high standard of care. Observations in communal areas and three individual rooms showed people looking clean, well cared for with hair brushed, teeth cleaned and nails cut or manicured. Observations during the morning showed people been treated in a respectful and dignified manner. Four care plans were examined and these clearly identified individual needs relating to health and personal care. One person said ‘I have really improved over the past few weeks’, another said ‘the care is wonderful and the staff really know how to care for me’. Risk assessments were in place relating to moving and handling, nutrition, the prevention of pressure sores and the risk of falls. These all ensure that people know their limitations in a risk assessed environment. Staff are aware of what equipment to use and aware of how to promote independence in a safe setting. Care plans had been reviewed and evaluated and staff have worked hard to implement Granby Court Extended Care Unit DS0000027931.V333711.R01.S.doc Version 5.2 Page 10 the new Four Seasons Healthcare paperwork. People have access to well trained registered nurses and access to continence advisors, doctors, physiotherapists and occupational therapists were evident (both in the care plans and during discussions in handover). Accidents are reported through the Regulation 37 notification system to the CSCI and audits of these takes place as part of the quality assurance system. Audits of care plans also takes place to ensure needs have been recorded and any changes are taken into account. Privacy and dignity is maintained (except on one occasion a staff member entered a room without knocking, though the ‘busy’ sign was on the door). All personal care is administered in a private room and visiting healthcare professionals are aware that this practice takes place. People were observed being addressed in a pleasant manner generally using Mr. or Mrs. when speaking. The medication system was inspected. The home have clear policies in place regarding staff administering medication and self administration. A monitored dosage system is used and the deputy has a good understanding of how to administer, record, store and dispose of medication. Charts were inspected and these had been completed correctly. Controlled drugs are stored and recorded appropriately and daily fridge temperatures are in place. Eye drops were kept in the fridge, following a discussion with the pharmacist it was evident that they do not need to be stored at this temperature once opened. The deputy took action to rectify this straightaway. This is also included in the audit and needs to be corrected. Three people spoken with confirmed they get their medication on time in a dignified manner. Staff receive medication training and are aware of how to practice safely. This helps to protect people from errors occurring. Granby Court Extended Care Unit DS0000027931.V333711.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 & 15 People who use the service experience good quality outcomes in this area. A range of activities are available, and autonomy is encouraged. Meals are provided to a high standard. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: People can participate in a range of activities which are organised by an activities organiser. Previous activities include flower arranging, walks along the Stray, entertainers, quizzes, one to one sessions and shopping trips. People can spend time in one of the communal areas or in their own room. Newspapers are available, music, and the television are all accessible and people’s individual needs are taken into account when activities are planned. Visitors are encouraged and the visitor’s book confirmed a range of people visit at different times of the day. One relative said ‘I am welcomed at any time, staff are always kind and friendly towards me’. Staff encourage independence but are aware of people’s limitations. Religious needs can be catered for, Holy Communion is offered on a monthly basis and different places to worship are available in Harrogate. People living in the home are from a range of backgrounds which was evident when speaking with people at lunchtime. Staff understand this and are keen to promote individuality. Granby Court Extended Care Unit DS0000027931.V333711.R01.S.doc Version 5.2 Page 12 The lunchtime meal was observed and examined, the dining area is a restaurant style room with a range of different size tables. Material napkins, tablecloths, glasses and flowers were all in place. People were offered assistance where required. On one occasion a member of staff was assisting a person but was speaking in a loud voice (this was observed from a table at the other end of the dining room). The member of staff then started chatting to other care staff which detracted from the person needing assistance. No action was taken regarding this from other staff. The food served was presented in an appealing and appetising manner. Three courses were offered and fresh vegetables and homemade deserts were evident. People complete menus the day before and a range of meat and fish dishes are always available. Alternatives are also offered with a range of drinks. People are able to use the bar for alcoholic drinks, and people were observed enjoying sherry, wine, and gin and tonic. The chef was spoken with who confirmed food hygiene training had been undertaken. Although other staff serving the food and drinks had not completed this. The chef has a good understanding of moulded and pureed food and is knowledgeable about fortifying food and ensuring people who are underweight have the right balance of nutrients in their diet. Whilst the dining experience was obviously enjoyable for people it was observed that toward the end of the main course noises from crockery been moved could be heard from near the kitchen area. This was quite loud and could have been avoided. It was also observed that the medication round takes place at lunchtime. One person was enjoying her main course then she had to stop and take some tablets. The manager needs to consider if this is appropriate. Granby Court Extended Care Unit DS0000027931.V333711.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People who use the service experience good quality outcomes in this area. Staff are aware of how to protect people and they have their concerns listened to. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: People were fully aware of how to raise any concerns or complaints. One person said ‘I would speak to the deputy or manager’, another person said ‘I have no concerns but I know what to do’. The procedure is on display and at the time of the site visit no formal complaints had been received through the CSCI, though a complaint had been investigated by the manager. A relative confirmed that she would speak to a member of staff if she was worried about anything. Staff spoken with were aware of who to complain to but some said they lacked confidence in the managers ability to deal with issues. People in the home said they felt safe, staff were observed moving people in a gently manner and talking to them respectfully. Three care staff were spoken with who confirmed what action they would take if they observed any form of abuse. Staff were clear about different types of abuse, and some training had taken place. Although two staff spoken with said they had not received training in this area. There is an adult protection procedure in place which includes whistle blowing and no-secrets document. All of which help to minimise the risk of harm to Granby Court Extended Care Unit DS0000027931.V333711.R01.S.doc Version 5.2 Page 14 people and protects individuals who give information to senior management. All staff have a protection of vulnerable adults check prior to being employed along with a criminal records bureau check. Granby Court Extended Care Unit DS0000027931.V333711.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 People who use the service experience excellent quality outcomes in this area. People live in a pleasant environment which is consistently clean and well maintained. Staff are aware of how to protect people and they have their concerns listened to. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: People are cared for in a home which is decorated to a high standard. The home employ a maintenance person and a decorator, along with a range of domestic staff. All areas inspected were clean and fresh smelling. The entrance area was welcoming and the furniture and fittings were based on hotel style accommodation. A small and large lounge are available with a library area accessible to everyone. Fish make the room relaxing and the atmosphere is quiet and pleasant. Three bedrooms with en-suite facilities were looked at. These varied in size, and some had wonderful views over the Stray. Staff undertake infection control training, though this is now part of the induction Granby Court Extended Care Unit DS0000027931.V333711.R01.S.doc Version 5.2 Page 16 process. Two staff in the laundry were spoken with who confirmed they are responsible for washing for two units and the nearby flats (over 80 people). There are two washing machines and driers, with a domestic iron and heavy duty iron available. The roller iron for sheets is broken and needs to be replaced. Staff were concerned regarding the damage that may be caused to themselves by the repetitive action of using the domestic style irons. This was discussed with the manager. People in the home all had clean and well-iron clothes. Three people confirmed that the home undertakes their laundry duties. Protective clothing is worn and staff are aware of cross contamination policies. Granby Court Extended Care Unit DS0000027931.V333711.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 & 30 People who use the service experience good quality outcomes in this area. People are cared for by well trained and recruited staff. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: People using the service are cared for by people in sufficient numbers. Though the nursing needs of people varies and this needs to be regularly reviewed, especially overnight, and because there are three floors. There are enough registered general nurses on duty, normally one nurse on each floor, then the care staff are allocated so many people to look after on each floor. Staff are competent, skilled and knowledgeable regarding this client group. A key worker system is in operation and communication between the nurses ands carers is very good. A ‘handover’ from the morning to the afternoon shift was observed which gave detail about each person and their current needs. Staff had a good understanding of each person and evidence showed that other healthcare professionals are liaised with when necessary. Currently a new call bell system is being fitted, staff are aware that they have to make more regular checks on people until the system is fully operational. No concerns were raised by people needing assistance, and no-one had to wait too long for a member of staff to come and help. As previously discussed one staff member used a loud voice when addressing a person in the dining room which could have been improved. This needs to be part of the induction training. Granby Court Extended Care Unit DS0000027931.V333711.R01.S.doc Version 5.2 Page 18 Many staff have completed an NVQ Level 2 or 3 in care. The home have exceeded the expectations regarding the percentage of staff trained to this level. This ensures that people are cared for to a basic good standard. Staff undergo induction training, this is equivalent to Skills for Care (standards for care practices and health and safety). Staff confirmed this takes place, although not all training records were up to date. Recruitment files were checked. Two carers and one registered nurses file were viewed. Staff always have two references and a criminal records bureau check along with a protection of vulnerable adults check prior to being employed. This was confirmed in all three files. In one file the nurses registration had expired, a list of all nurses and their identification numbers was available but on two occasions these had expired and had not been checked, and a further two were due to expire at the end of the month. Following a discussion with the manager checks with the nurses and midwifery council were made and whilst the nurses did have registration details in date these had not been recorded anywhere. This needs to be completed to ensure people using the service are protected. Granby Court Extended Care Unit DS0000027931.V333711.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 & 38 People who use the service experience good quality outcomes in this area. The home looks after the best interests of people who also have their financial and health and safety needs met. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: The home is run in the best interests of people using the service. The registered manager is a registered general nurse with many years experience in caring for this client group. She has completed an NVQ Level 5 in management and has the skills, and knowledge needed to ensure individual needs are being met. The manager is well supported by the deputy, who has been in post for a few months. People using the service generally spoke highly about the manager, although some people said they would speak to the operations manager if they had a serious issue. Some staff had confidence in Granby Court Extended Care Unit DS0000027931.V333711.R01.S.doc Version 5.2 Page 20 the manager though others felt some issues were not dealt with effectively. For example, if extra hours are available staff felt they should be offered these first rather than getting bank staff to cover these shifts, as this helps with consistency. They felt certain staff got preferential treatment. The manager needs to ensure she is giving everybody the same opportunity and this is effectively communicated to all staff. It is extremely important that staff have confidence in the managers abilities to deal with situations, this then has a positive effect on the staff and ensures people using the service are not affected. Quality assurance in the home was discussed. People said they discuss their views and opinions verbally, residents meetings take place and surveys and questionnaires are completed on an annual basis. The home has the investors in people award and is keen to develop this area further. Currently a range of audits take place including care planning, accidents, medication, kitchen audits and health and safety. The home only deals with a few people’s finances. Generally people are invoiced for additional items, For example hairdressing, chiropody, drinks form the bar. Some people prefer to have some money on the premises where comprehensive records are kept. People spoken with confirmed this was the case. Health and safety in the home was observed and discussed with the maintenance person. No hazards were identified (apart from a radiator cover was loose near the entrance area). Records of water temperatures are kept and three sinks were tested and found to be within the expected range. Fire safety procedures are in place which include emergency lighting, some detectors and staff receive training in this area on a regular basis. Moving and handling equipment is checked and contracts for the lifts are in place. A range of certificates were evidenced in the pre-inspection questionnaire and staff have a good understanding of how to keep people safe. On one occasion the cupboard at the end of the corridor was left unlocked, this contained old notes of people who previously used the service. Staff need to ensure this is kept locked. A discussion took place regarding mandatory training, currently there is not always a first aider on duty. Though registered nurses are always on shift they have not had specific first aid training. Some staff have not received food hygiene training (including catering staff), and three sets of training files were looked at and these were not up to date. For example one persons record stated 2002 was the last fire training they had received, though a training matrix stated 2007. It is the staff’s responsibility to keep their own records up to date, but this is overseen by a mentor. The training matrix was viewed at the site visit which showed ‘gaps’ in induction, moving and handling and infection control, and food hygiene. However the following day a more up to date training plan was forwarded to the CSCI which was completed more Granby Court Extended Care Unit DS0000027931.V333711.R01.S.doc Version 5.2 Page 21 thoroughly. However, the manager must ensure records are kept up to date to ensure she is aware of the training people have received. This will also make sure people are cared for by suitably trained people. Granby Court Extended Care Unit DS0000027931.V333711.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 4 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 4 x x x x x x 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x 3 3 Granby Court Extended Care Unit DS0000027931.V333711.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? no STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP9 Regulation 13 Requirement Eye drops must be stored correctly to ensure they are administered at the correct temperature. This must be checked on the audit system. People need to be served food and drinks by staff who have been trained in food hygiene. Staff need to undertake first aid training to ensure in an emergency situation people are cared for appropriately. Updated record of nurses registration needs to take place. This will ensure staff are practicing within the nurses and midwifery council, and people will then be cared for by suitably trained people. When any training is completed records need to be updated. Timescale for action 13/06/07 2. OP38 16 13/08/07 3. OP38 13 13/08/07 4. OP37 17 13/06/07 Granby Court Extended Care Unit DS0000027931.V333711.R01.S.doc Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP30 Good Practice Recommendations People need to be cared for by care staff who have a suitable tone and appropriate volume of sound when speaking. The manager needs to ensure staff have confidence in her abilities to deal with their concerns. 2. OP31 Granby Court Extended Care Unit DS0000027931.V333711.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Granby Court Extended Care Unit DS0000027931.V333711.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!